Akut İnvaziv Fungal Rinosinüzit Tanılı Diabetes Mellitus Hastalarında Tedavi ve Prognozu Etkileyen Faktörler

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Aim: Acute invasive fungal rhinosinusitis (AIFRS) which is a serious disease with a high morbidity and mortality rate is mostly seen in diabetic and immunocompromised patients.Methods: In this study, seventeen diabetic patients who were treated for AIFRS in Çukurova University Faculty of Medicine, Department of Otorhinolaryngology between January 2010 and January 2020 were retrospectively analyzed from medical records.Demographic characteristics, risk factors, complaints at presentation, age at diagnosis, localization of fungal sinusitis, operation type, preoperative examination and lesion extensity, factors affecting prognosis and treatments of the patients were evaluated.Results: The mean age of the patients was 52 years.47% (n:8) of the patients were female and 53% (n:9) were male.All patients were diabetic, 2 patients had additional chronic renal disease and 1 patient had chronic liver disease.The most common presenting symptoms of patients with AIFS were facial swelling and pain (58.8%), periorbital edema (41,1%) and fever (35.2%).We performed endoscopic sinus surgery in 12 patients, open and endoscopic sinus surgery in 5 patients and orbital exenteration in 4 patients.The overall survival rate was 53%.Intracranial extension, high HbA1c level and advanced sinonasal involvement were found to be poor prognostic factors.Conclusions: Acute invasive fungal rhinosinusitis is still a disease with high mortality despite surgical and medical treatment.Because of diabetes-related immunosuppression, when any sinonasal symptoms and signs observed in these patients, clinicians should raise suspicion for invasive fungal rhinosinusitis.